“Don't want to have surgery for enlarged heart--any other options?”
I am only 33 (male) but I have just been diagnosed with an enlarged heart after a chest x-ray. My doctor seems to think surgery is unavoidable. What other options are out there?
9 Answers
There are many reasons for enlarged heart and there are many ways to treat that including medications and some devices like the defibrillator. Surgery is the last option.
Options available very much depend on your diagnosis, since a heart can be enlarged for multiple reasons. For example, if you have valve disease ( your heart has four one way valves to keep blood moving in the right direction) that can cause an enlarged and weak heart. In certain instances then, medicine can help but if the disease is severe, then surgery is usually more effective. Or you may have an enlarged heart from weakened heart muscle. When medical therapy for heart failure is no longer effective, then once again surgery has a role. I encourage you to speak with your doctor to make sure you understand the problem with your heart so you can make informed choices for treatment. I wish you all the best.
Medications may help. If it is due to heart valve problems, surgery may be needed to help correct the problem
There are many causes of an enlarged heart, or cardiomegaly. Common causes include hypertension, coronary artery disease, valve disease or even fluid around the heart. It is very important to have a full workup of the heart and lungs to exclude common etiologies. Many of these causes are much less common at age 33, but determining which one is critical to take steps to treat this. Surgery is helpful in some of these diagnoses, but your doctor likely will use this as a last resort.
Surgery will depend on the reason why the heart is enlarged
There needs to be a diagnostic work-up to determine the cause for your enlarged heart. Once that is known, then we can discuss treatment and whether surgery is needed or not.
The necessity for surgical therapy would depend upon the cause of the enlarged heart. In your age group, there are several possible reasons for enlargement, including both "surgical" and "medical" causes. All of these are collectively known as "cardiomyopathies". Among the "surgical" causes include leaking valves, blockage in the coronary arteries (with damage from heart attacks), and some congenital abnormalities which involve improper development of the heart before or shortly after birth. The medical reasons can involve viruses, alcohol, and some other reasons that lead to what is known as a dilated cardiomyopathy for which surgery can do little to help. In any event, tests in addition to a chest x-ray are required to determine the reason for your enlarged heart, which will lead to a recommendation about which types of therapy might be of benefit to you.
In order to provide you the best advice, your case needs to be carefully evaluated by a heart failure cardiologist to determine the best treatment options for you. Based on the information provided above, I am unable to offer a clear cut answer.
Juan P. Montoya
Cardiothoracic Surgeon
Thanks for your question. It depends on the cause of your enlarged heart. If your doctor saw your CXR and said you have an enlarged heart and based his opinion of needing surgery on that, that is not correct. Further testing such as an echocardiogram needs to be done to actually see what going on, the cause of the enlarged heart. Many different causes exist including leaky valves, tight valves and disease of the heart muscle itself.
Depending on the cause and the symptoms, then the decision to manage medically or surgically can be made. Until all of the diagnostic testing is done to rule out certain things and actually find the cause of this enlarged heart, no assumptions should be made. Hope this helps!
Depending on the cause and the symptoms, then the decision to manage medically or surgically can be made. Until all of the diagnostic testing is done to rule out certain things and actually find the cause of this enlarged heart, no assumptions should be made. Hope this helps!
